Primary Care Coding Alert

Question: What is the correct ICD-10 code for chronic back pain? Can I use M54.9?

Codify Subscriber

Answer: You can code back pain with M54.9 (Dorsalgia, unspecified). But per ICD-10 guidelines, “chronic pain is classified to subcategory G89.2.” Assuming the pain is not due to a thoracotomy or other procedure or due to trauma, which have their own codes, G89.29 (Other chronic pain) is a better choice in this situation.

Coding caution: The guideline also goes on to note two very important criteria when using G89.2. First, it tells you that “there is no time frame defining when pain becomes chronic pain,” and it continues by noting that “the provider’s documentation should be used to guide use of these codes.” In other words, it is up to the provider to determine what constitutes chronic pain; and second, as with any diagnosis, you should only use this code when your provider documents the condition in this way.